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Work Activity Work Order `"'�" ' <br /> to;�t/::��:5 :s�.• - <br /> ISSU2d By HLJ MUSBV,LANCE J. <br /> Issued Department aw PUOLIC WORNS <br /> Date Issued snaizo�e <br /> Fund so� Account 5 Program Functic� AcUvrty <br /> Program uraa» o a <br /> TiUO CONVERT 751NCH t876 WF T�dORE AVE UT3773�6�3 <br /> WOfk �fdEf r:0 2��SZ�39 Pro;eC Actwity Type CORRECTIVE AIAINTEN�NCE SI2fUS CL <br /> StaWs �n4rzo�s Time ��se Original W0 E3dl�ng _ _ ____ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Streel <br /> Apartment No City <br /> State Z�P <br /> Subdrvision Change Map Y!N <br /> Phone No � � • Ext <br /> Second Phone � � - Ext -- <br /> E-Mad Address - <br /> Problem Information <br /> Address �gy6 Street �4TH ST <br /> From Cross Sireet <br /> To Cross Street <br /> City Lp <br /> Subdiw;ion Map Book A4ap Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OrHER <br /> Requested By Date Requested <br /> Agency Related Reyuesl <br /> In�hated From <br /> Uhhty Locate(USA) No Called Oale Expuation Dale <br /> Assignment Inlormation <br /> Dept Prionry Estimated Hours <br /> Crew <br /> Conlracror <br /> Assiqned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Date _ Scheduled Time �'�� `:'�. ,`.���! ! ,�`*�. <br /> Route Route Sequence - i-: <br /> Comments <br /> Action Taken CONVERT.751NCH CURBSTOP TO .751NCH SETTER WITH MET[R AND BOX. FLAT TO METER <br /> PROGRAM. <br /> Recommended Action <br /> Approved By EAL ERICKSON,ANDREW L Job Cost Information(Y/N) <br /> Start Date � r Time _ Date Completed 9121l2015 Permit No _ <br /> Completed By Time Follow Up^ <br />